Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Otolaryngol Head Neck Surg. 2011 Jan;144(1):67-72. doi: 10.1177/0194599810390917.
To evaluate the usefulness of video pneumatic otoscopy (VPO) for the diagnosis of conductive hearing loss (CHL) with normal tympanic membranes (TM).
Prospective study.
Tertiary care hospital.
Thirty-seven ears with CHL and 9 control ears with normal TMs were included. The VPO was performed preoperatively in all patients. The authors captured TM images in 3 stages of the VPO (static, positive, and negative pressure stage) in all subjects and measured the amount of relative position differences of the umbo. Pure-tone audiometry and temporal bone computed tomography (TBCT) were performed preoperatively. The possible causes of hearing loss were evaluated during exploratory tympanotomy in the patients with CHL.
Fifteen patients had stapedial fixation, 10 had fixation of the malleus or incus (MIF), and 12 had ossicular discontinuity. The positional differences between the negative and positive pressure stage of the MIF group were significantly smaller between the CHL and control groups (P = .001). The air-bone gap showed no significant difference among the CHL groups. The sensitivity, specificity, and diagnostic accuracy of the VPO for the diagnosis of MIF, with a cutoff value of 1.5% or less in terms of the movement of umbo, were 80.0%, 92.6%, and 89.2%, respectively. These findings were comparable to those of the TBCT, which were 90.0%, 85.2%, and 86.5%, respectively.
The VPO is a simple, noninvasive, and accurate tool for the differential diagnosis of CHL with a normal TM.
评估视频气动耳镜（VPO）在诊断正常鼓膜（TM）的传导性听力损失（CHL）中的作用。
前瞻性研究。
三级保健医院。
37 耳 CHL 和 9 耳正常 TM 的对照组。所有患者均行术前 VPO。作者在所有受试者的 VPO 的 3 个阶段（静态、正压和负压阶段）中捕获 TM 图像，并测量了 umbo 相对位置差异的量。所有受试者均行术前纯音测听和颞骨计算机断层扫描（TBCT）。在 CHL 患者中，通过探查性鼓室切开术评估听力损失的可能原因。
15 例患者存在镫骨固定，10 例患者存在锤骨或砧骨固定（MIF），12 例患者存在听小骨连续性中断。MIF 组负压和正压阶段之间的位置差异在 CHL 和对照组之间有显著差异（P =.001）。CHL 组的气骨间隙无显著差异。VPO 对 MIF 的诊断的灵敏度、特异性和诊断准确性，以 umbo 运动 1.5%或以下为截断值，分别为 80.0%、92.6%和 89.2%。这些发现与 TBCT 的结果相当，分别为 90.0%、85.2%和 86.5%。
VPO 是一种简单、无创、准确的工具，可用于诊断正常 TM 的 CHL。
